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Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Note: This is a post by Katherine Rourke. Tomorrow watch for a post by John on EMR and EHR where he discusses some of his views on this discussion.

While it may not be immediately obvious, the EMR industry is at a major turning point in its history. Any day now, we’re going to see a bunch of mergers and acquisitions go off like a string of firecrackers, some of which may have a direct impact on your business.

Now, I don’t know how many EMR companies there are out there. In fact, I’m not sure anyone has a precise count. But can we agree that we’re looking at 1,000 or more, no? And, heck, there’s probably thousands of companies pitching practice management + EMR, medication management systems, clinical decision support, apps, mobile health plug-ins to EMRs and so on. Just visualize it all — you’ll get a headache but you’ll doubtless agree that we’re dealing with a raging flood of technology.

And most of it won’t stand alone forever. Every vendor likes to say that their product line has all the solutions, but even the most green sales rep doesn’t really believe that. Smart EMR tech firms and their natural allies are already beginning the mating dance, and quietly but inexorably, hooking up.

Since this isn’t the Wall Street Journal, I’m sure we don’t need to dig into deep financial discussion over this. And anyone who’s a regular reader of this site knows why software companies often buy rather than build the technologies they need to fill out their portfolio.

But I thought it was still worth noting that within, say, 18 months, the EMR world could look fairly different in the following ways:

* EMRs aimed at doctors are overabundant, to put it mildly. I predict that there will be a dozen or so well-publicized failures or buyouts in this space within the next year.

* Big vendors that pitch to both enterprises and medical practices will largely have to pick one,and it’s the enterprise side that will win. If you’re a doctor running a giant company’s EMR, stay in regular touch with your vendor and get their support promises in writing!

* There will be a flurry of mHealth activity, with EMRs that play nicely on tablets in center stage. It’s possible the market will even support another IPO or two this year by EMR vendors if they’re offering a nifty mobile health aspect integrated with their core product.

* Doctors, in particular, risk finding that their product becomes abandonware this year as the market consolidates. Have a Plan B available, and I mean a written plan developed by a consultant or tech-savvy senior member of your team.

So, what else do you think will happen as the market absorbs excess players and recombines relationships?

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m pretty sure that many readers of this site haven’t found my new EMR related website called EMR and EHR Thoughts and so you might have missed the post I did about Greenway Medical filing to go public. This is obviously big news for Greenway, but I also think it’s a sign of things to come. I believe that Greenway is likely the first of many EHR companies that we’ll see go public over the next year or so.

I’m sure that many of you haven’t followed the trends of tech company IPO’s and I’m far from an expert on this. However, the IPO window which was generally closed for tech companies now seems to be open after a number of successful public offerings from tech companies. I’m not sure why it took me so long to realize this, but I believe that we’re going to see a number of IPO’s from the larger privately held EHR companies during this period as well (Don’t be surprised if even Epic can’t resist).

Many people in silicon valley are suggesting that we’re in a startup internet bubble that in some ways is similar to the initial dot com (or bomb if you prefer) bubble. When you look at startup company valuations, I believe this is definitely the case. In some similar ways, we are also in an EHR bubble. However, I don’t believe this EHR bubble is going to pop for a couple years.

The obvious reason we’re in an EHR bubble is the EHR stimulus money. That’s going to continue to hold the EHR bubble up for at least another 2-3 years. Then, the real fun (or sadness depending on your position) is going to start to set in. However, until then HIMSS, MGMA and other EHR related conferences are going to have some really great parties.

We’ll see what the post EHR bubble looks like, but I can see a number of EHR companies enjoying the benefits of an IPO during the current bubble.

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